Familial predisposition for degenerative disc disease. A case-control study

STUDY DESIGN

This case-control study was undertaken to determine if relatives of patients who had been admitted for surgery for degenerative disc disease-related problems were at increased risk for lower back pain or sciatica.

OBJECTIVES

To determine if familial factors play a role in placing a person at risk for development of degenerative disc disease of the lumbar spine.

SUMMARY OF BACKGROUND DATA

It is known that smoking and various occupational factors can place a person at risk for degenerative disc disease problems. It is not known if a familial predisposition may also exist.

METHODS

The family members and relatives of 65 patients who had undergone surgery for lumbar degenerative disc disease were interviewed with a standardized questionnaire and compared with a control group of 67 patients who had been admitted to hospital for non-spine-related orthopedic procedures. The same interview and standardized questionnaire was used for both groups by a single observer.

RESULTS

In the study group of 65 patients who had undergone surgery for degenerative disc disease, 44.6% were noted to have a positive family history, whereas 25.4% of the patients in the control group had a positive family history. Eighteen and one-half percent of relatives in the study group had a history of having spinal surgery, compared with only 4.5% of the control group.

CONCLUSIONS

The results indicate that a familial predisposition to degenerative disc disease can exist along with other risk factors.

Polynucleotide phosphorylase is required for the rapid degradation of the RNase E-processed rpsO mRNA of Escherichia coli devoid of its 3' hairpin

The monocistronic transcript of rpsO undergoes an endonucleolytic cleavage downstream of the coding sequence, which removes the hairpin of the transcription terminator and initiates the rapid degradation of the message. We demonstrate here that the two rne-dependent cleavages, on both sides of the transcription terminator, are catalysed by RNase E in vitro and that the RNase E-processed rpsO message is rapidly degraded by polynucleotide phosphorylase, while RNase II produces stable decay intermediates. Moreover, we show that RNase E cuts in vitro the coding sequence of the rpsO mRNA at several sites which are not detected in vivo.

Multiple degradation pathways of the rpsO mRNA of Escherichia coli. RNase E interacts with the 5' and 3' extremities of the primary transcript

The degradation process of the rpsO mRNA is one of the best characterised in E coli. Two independent degradation pathways have been identified. The first one is initiated by an RNase E endonucleolytic cleavage which allows access to the transcript by polynucleotide phosphorylase and RNase II. Cleavage by RNase E gives rise to an rpsO message lacking the stabilising hairpin of the primary transcript; this truncated mRNA is then degraded exonucleolytically from its 3' terminus. This pathway might be coupled to the translation of the message. The second pathway allows degradation of polyadenylated rpsO mRNA independently of RNase II, PNPase and RNase E. The ribonucleases responsible for degradation of poly(A) mRNAs under these conditions are not known. Poly(A) tails have been proposed to facilitate the degradation of structured RNA by polynucleotide phosphorylase. In contrast, we believe that removal of poly(A) by RNase II stabilises the rpsO mRNA harbouring a 3' hairpin. In addition to these two pathways, we have identified endonucleolytic cleavages which occur only in strains deficient for both RNase E and RNase III suggesting that these two endonucleases protect the 5' leader of the mRNA from the attack of unidentified ribonuclease(s). Looping of the rpsO mRNA might explain how RNase E bound at the 5' end can cleave at a site located just upstream the hairpin of the transcription terminator.

[Efficacy of partial inferior turbinectomy in the treatment of nasal obstruction. Retrospective study apropos of 71 patients]

Longtime discredited, practiced with reticence even today, the inferior turbinectomy represents the treatment of choice in patients with persistent chronic nasal obstruction despite medical treatment or cauterization. Between January 1989 and December 1995, 81 patients underwent an isolated bilateral inferior turbinectomy (without an associated septal or sinus intervention). This retrospective study analyzes the short and long-term results in 71 patients with a one year minimum follow-up. Turbinectomy was in all cases always partial and managed under endoscopic guiding. Mean follow-up was 33 months, based on a patient's questionnaire. No cases of crusting rhinitis were observed. 81,7% of patients were improved by the surgical intervention. In asthmatic patients, no worsening of the asthma was noted, whereas in 28,5% of these cases, there was an improvement or disappearance. Non serious adverse effects appear after surgery as rhinorrhea (16%) and post nasal drip (18,4%). The surgical turbinate reduction represents an option in the care of patients with chronic nasal obstruction associated with inferior turbinate hypertrophy.

Histology and electron microscopy of fucosidosis of the skin. Subtle clues to diagnosis by electron microscopy

Fucosidosis is an autosomal recessive inborn error of metabolism in which fucose-containing glycolipids, glycoproteins, and oligo- and polysaccharides accumulate in tissues as a consequence of alpha-L-fucosidase deficiency. Since the detection of this entity in 1966 several cases have been described, but until now investigations of clinically uninvolved skin have not been performed. In this study we have investigated clinically normal skin obtained from a patient with fucosidosis and his healthy sister, by light and electron microscopy, to determine whether normal skin in this condition yields clues that may have prognostic relevance. We found "empty"- appearing storage vesicles in melanocytes, endothelial cells, sweat glands, and fibroblasts in the skin.

Polyadenylylation destabilizes the rpsO mRNA of Escherichia coli

The rpsO mRNA, encoding ribosomal protein S15, is only partly stabilized when the three ribonucleases implicated in its degradation--RNase E, polynucleotide phosphorylase, and RNase II--are inactivated. In the strain deficient for RNase E and 3'-to-5' exoribonucleases, degradation of this mRNA is correlated with the appearance of posttranscriptionally elongated molecules. We report that these elongated mRNAs harbor poly(A) tails, most of which are fused downstream of the 3'-terminal hairpin at the site where transcription terminates. Poly(A) tails are shorter in strains containing 3'-to-5' exoribonucleases. Inactivation of poly(A) polymerase I (pcnB) prevents polyadenylylation and stabilizes the rpsO mRNA if RNase E is inactive. In contrast polyadenylylation does not significantly modify the stability of rpsO mRNA undergoing RNase E-mediated degradation.

Measurement of blood concentrations of FK506 (tacrolimus) and its metabolites in seven liver graft patients after the first dose by h.p.l.c.-MS and microparticle enzyme immunoassay (MEIA)

1. Blood and urine concentrations of the macrolide immunosuppressant FK506 and its metabolites were measured in seven orthotopic liver transplant patients after the first oral dose of FK506 (0.04 +/- 0.02 mg kg-1) used as primary immunosuppressant. A specific h.p.l.c.-MS assay was used, allowing the measurement of parent drug and eight metabolites. Results were compared with those obtained using a microparticle enzyme immunoassay (MEIA). 2. Blood drug concentrations were described by an open two compartment model with first-order absorption giving the following mean data: tmax: 1.9 (h), Cmax: 17.4 (microgram l-1), AUC: 328.1 (microgram l-1 h), t1/2,1: 0.74 (h). The terminal elimination half-life was estimated at about 26 h using the h.p.l.c.-MS assay. 3. The metabolites found in blood were demethyl-FK506 and demethyl-hydroxy-FK506, while in urine FK506 and eight of its metabolites were detected.

Specific and sensitive measurement of FK506 and its metabolites in blood and urine of liver-graft recipients

A specific and sensitive assay for quantifying the immunosuppressant FK506 and its metabolites in blood and urine was developed. 32-O-Acetyl FK506 was synthesized and used as internal standard. FK506 and its metabolites were purified from the samples by solid-liquid extraction and were injected into a high-performance liquid chromatographic (HPLC) system linked to a mass spectrometer (MS) by particle-beam interface. The FK506 derivatives were separated from interfering material by use of a 100 x 4 mm C8 analytical column and water/acetonitrile or water/methanol gradient elution; they were detected by negative chemical ionization with methane as reagent gas. The limit of detection was 25 pg in a standard solution, and the limit of quantification in blood was 250 pg (extracted from 1 mL of blood). The CV was 11.3% at 5 ng, and no interferences with other drugs were found.

Specific and Sensitive Measurement of FK506 and Its Metabolites in Blood and Urine of Liver-Graft Recipients

A specific and sensitive assay for quantifying the immunosuppressant FK506 and its metabolites in blood and urine was developed. 32-O-Acetyl FK506 was synthesized and used as internal standard. FK506 and its metabolites were purified from the samples by solid-liquid extraction and were injected into a high-performance liquid chromatographic (HPLC) system linked to a mass spectrometer (MS) by particle-beam interface. The FK506 derivatives were separated from interfering material by use of a 100 x 4 mm C8 analytical column and water/acetonitrile or water/methanol gradient elution; they were detected by negative chemical ionization with methane as reagent gas. The limit of detection was 25 pg in a standard solution, and the limit of quantification in blood was 250 pg (extracted from 1 mL of blood). The CV was 11.3% at 5 ng, and no interferences with other drugs were found.

Binding sites for atrial natriuretic peptide on platelets in patients with congestive cardiomyopathy

The aim of the present investigation was to evaluate a possible down-regulation of atrial natriuretic peptide (ANP) binding sites on platelets in patients with chronically elevated ANP plasma levels. The assay procedure was proved to be able to measure the total number of binding sites even in the presence of high ANP plasma levels. We studied 15 adult patients with congestive cardiomyopathy in comparison to 18 healthy volunteers. In the patients the median ANP plasma level (median = 375, range: 155-900 pg ml-1) was about six-fold higher than in the healthy volunteers (median: 55.5, range: 20-90 pg ml-1). The median cyclic guanosine monophosphate (cGMP) plasma level (median: 6.2, range: 2.5-21.4 pmol ml-1) was about three-fold higher than in the healthy volunteers (median: 1.8 range: 1-2.8 pmol ml-1). Despite these markedly elevated ANP and cGMP plasma levels we did not find significantly less receptors per platelet in the patients (median: 19, range: 7.2-60.2) than in the healthy volunteers (median: 24.5, range: 14.8-41.1). Furthermore, there was no difference in the dissociation constants between the patients (median: 10.5, range: 7.9-27.4 pmol l-1) and the control subjects (median: 8.9, range: 5.4-17 pmol l-1).

Level of ribosomal RNA required for stimulation from quiescence increases during cellular aging in vitro of mammalian fibroblasts

We have investigated the relation between cell size in terms of cellular ribosomal RNA (rRNA) content and proliferation of diploid human and rat embryo fibroblasts during their aging in vitro. During phase III of the proliferative lifespan in vitro, cellular rRNA content increases by a factor of nearly 3. For very different regimes of stimulation of quiescent cells, a strict correlation was observed, between the proportion of cells stimulated and cellular rRNA content, resembling a steep threshold curve. During aging in vitro, these characteristic curves exhibit an essentially parallel shift to higher values of cellular rRNA content (to higher 'thresholds'). Upon establishment as a permanent cell line, the relation between proliferation stimulation and cellular rRNA ceases to change with further subculturing. It is suggested that the essence of transformation of fibroblasts with a myc-type of oncogenes is a reduction and stabilizing of the critical rRNA content required for proliferation.

[A multidisciplinary approach to algodystrophy of the hand]

A multidisciplinary approach for the management of reflex sympathetic dystrophy at SOS Main of Strasbourg has been progressively adopted due to the severe functional sequelae of this disease. The TC99 bone scan in three phases has allowed us after a one week duration of the symptoms to make an early diagnosis and to start dynamic splinting in flexion. Our study compares two groups of patients, one with an early treatment and the other with delayed treatment. It shows a correlation between the stiffness of the affected hand and the isotopic findings. The benefit from an early dynamic splinting in flexion as evidenced by a clinical improvement is corroborated by the bone scan.

[Effect of a synthetic detergent (Syndet) on the pH of the skin of infants]

The long- and short-term effects on the skin of infants of a synthetic detergent (syndet) with an acid pH were investigated and compared to ordinary soap. The short-term effect was determined by measuring the skin pH on different parts of the body before and 20 min after washing with syndet. The long-term effect was tested in a second group, in which the infants were washed either with ordinary soap or with syndet for 3 days. The skin pH was measured 4-5 h after washing. The results were evaluated statistically. The results show that for a short time syndet displaces the skin pH towards acid pH in younger infants; however, the skin pH is not influenced in older infants. Syndet keeps the skin pH in the physiological range for a longer time after washing than ordinary soap.

[The septic state in infancy]

In a retrospective study it was investigated in which a course the septicemia appears during the first year of life and which laborchemical and immunological findings are typical for the specific manifestation and can be used for the diagnosis. 27 sucklings with septicemia were admitted at our hospital during 1976-1982. As the clinical course we found: the acute septicemia with pronounced shocksymptoms (Septic-Toxic-Course, STC), the septicemia with a tardy course and hematogenous dispersion of bacteria in one organsystem, namely in the brain (Meningoencephalitis), in the bone (Osteomyelitis) and in the soft tissue (Phlegmon), the septicemia with a tardy course and forms a septicopyemia with secundary dispersion of bacteria in multiple organsystems. Only STC and septicopyemia show the symptoms which are lead back with the dispersion of bacteria. By the septicemia with a tardy course and hematogenous dispersion of bacteria in one organsystem the clinical symptoms are determined only in the infected organ. As the only course of septicemia the STZ shows laborchemically in the blood a damage to the livercells with a constant elevated levels of plasmaencyms GOT, GPT and LDH; this findings can be used for a diagnostic criterion. By septicopyemia, meningitis and osteomyelitis the findings of sepsis exist in the blood but are rare by phlegmon. By septicemia with a tardy course (2, 3) a humoral and/or cellular immundeficiency exist. This is a point of application for therapy to give biological antibody with a large spectrum.